Leptospirosis

Leptospirosis Outbreak in AZ:

A recent outbreak of leptospirosis in dogs was identified in Maricopa County, Arizona. As of May 23, 2017, over 70 dogs in Maricopa County have been diagnosed with leptospirosis during the last year (since February 2016). The outbreak is still ongoing.

To date, none of the people with exposure to the sick dogs have been diagnosed with leptospirosis, however a few have illnesses that are currently being investigated.

Leptospirosis, a bacterial disease that can affect people and animals, has been on the rise in Maricopa County dogs since February, 2016. The bacteria that causes leptospirosis is spread in the urine of infected animals, including rodents, wildlife, pets, and livestock. People and dogs can be infected through contact with infected urine or urine-contaminated water or wet soil. Dogs with leptospirosis can potentially spread the infection to people and those that work with animals may be at increased risk for infection. Dogs with leptospirosis can shed the bacteria in their urine for up to several months, even if they don’t have symptoms.

A leptospirosis vaccine is available which can help prevent infection and disease, and should be discussed with the dog’s veterinarian. The vaccine does not have a higher likelihood of causing vaccine reactions than any other vaccine. Exercise standard precautions in dogs with a history of serious vaccine reactions or in which vaccination is contraindicated.

People with symptoms of leptospirosis most often have mild flu-like symptoms, however occasionally severe illness resulting in liver or kidney damage can occur. Symptoms of leptospirosis in people include:

People typically get sick about a week after they are exposed but it can take as little as 2 days and as long as 30 days for someone to show symptoms. Most people do not show any signs of illness. Certain types of leptospirosis can be more severe, especially for people who are older or have underlying medical conditions.

Prevention

Wear protective clothing (such as gloves and gowns/coveralls) and waterproof shoes or boots to avoid exposure to contaminated urine or urine-contaminated water or soil.

Cover any cuts or wounds with waterproof dressings before potential exposure to contaminated infected animals, or contaminated urine or water.

Avoid swimming and other recreational activities in water that may be contaminated with animal urine, or drinking potentially contaminated water.

Avoid contact with rodents and wildlife to reduce exposure to the bacteria.

Additional Materials

Based on the serologic reaction profiles of the leptospirosis testing performed on the dogs so far, L. canicola and L. gryppotyphosa are reacting the most. Definitive identification of the infecting serovars would require culture, which has not been able to be performed on any of the dog samples yet. The 4-way leptospirosis vaccine for dogs covers L. canicola, L. gryppotyphosa, L. icterohemorrhagiae, and L. Pomona.

Pregnant or immunocompromised individuals especially should avoid contact with potentially infected dogs and their urine

Wear protective equipment such as gloves, face shield or mask, and gown when caring for ill patients or cleaning up their urine or other body fluids

Wash hands with soap and water after interacting with patients or cleaning up their urine/body fluids

Infected dogs should be placed in floor-level cages, if possible, and housed away from high-traffic areas to limit urine-contamination.

Infected dogs should be walked in a designated and easy to clean area, with hard, non-permeable surfaces, away from other dogs.

Use 1:10 (1 part bleach and 9 parts water) solution or other antibacterial disinfectant cleaning solutions to clean areas where infected dogs are housed, where they have urinated or other areas contaminated by body fluids

Normal laundering of urine-contaminated bedding and towels will inactivate the bacteria

Avoid aerosolization of bacteria through activities such as pressure washing runs where dogs are housed

Notify public health and seek medical attention if staff that have been caring for infected dogs develop signs of illness

Start infection control procedures for any dog suspected of having leptospirosis (while awaiting laboratory confirmation)

Kennels should be clearly marked with warning label to alert people to the presence of a leptospirosis positive or suspect dog.

Ask owners if their dog has been recently ill or been previously vaccinated against leptospirosis.

If a dog owner, family member, or veterinary or boarding/daycare staff develops flu-like illness, they should seek medical care from their doctor and notify their local public health official.

Additional Materials

Keep leptospirosis on the differential for people with compatible symptoms, especially for those with a dog with recent illness or diagnosis of leptospirosis

The incubation period ranges from 2–30 days, with illness usually occurring between 5–14 days of exposure.

The majority of people who are infected with leptospirosis are asymptomatic. Diagnostic testing is not currently recommended for asymptomatic individuals.

Those who have symptoms typically experience flu-like illness including fever, headache (can be severe and include retro orbital pain and photophobia), myalgia (especially calves and lower back), conjunctivitis without purulent discharge, nausea/vomiting, diarrhea, cough, abdominal pain, and a rash (rare).

Severe disease occurs in up to10% of symptomatic persons and can involve renal and hepatic failure, meningitis, and/or respiratory distress. Approximately 5-15% of severe cases are fatal.

If you suspect that a person has leptospirosis, begin appropriate antimicrobial treatment as soon as possible (without awaiting diagnostic test results), as early treatment may help decrease the severity and duration of disease. Doxycycline (oral) or penicillin (IV) is usually the antibiotic of choice, however other options are available.

Confirmatory diagnostic tests for leptospirosis include PCR on blood or urine specimens, and serology with the microscopic agglutination test (MAT). Serology by ELISA is a screening test, and positive results should be confirmed by MAT.

Report suspect leptospirosis cases to the Maricopa County Department of Public Health at 602-506-6767